When Diarrhea Gets Deadly: A Look at Gastroenteritis Outbreaks in Nursing Homes

Although generally self-limited, infectious gastroenteritis can be associated with substantial morbidity and mortality. Elderly persons are at particularly high risk of adverse outcomes. There are currently 11.4 million people living in nursing homes in the United States [1], including almost 14% of the population aged 184 years. Residents of long-term care facilities (LTCFs) in the United States are 4 times more likely to die from gastroenteritis than community dwellers [2] and account for 17.5% of deaths due to diarrheal disease [3]. The article by Kirk et al [4] in this issue of Clinical Infectious Diseases describes gastroenteritis outbreaks in LTCFs in Australia, with important lessons for other countries as well. This Australian study used data from a register of foodborne disease outbreaks in sentinel surveillance sites, which was expanded in 2002 to include gastroenteritis outbreaks due to any mode of transmission. Unfortunately, it is only in the past year that such a comprehensive surveillance system has been instituted in the United States; thus, it will be some time before reliable national data are available